On May 1, 2002, a law on the prevention and control of occupational diseases has been approved by the National People’s Congress Standing Committee to protect worker’s health in China. Since 2003, April 25 to May 1 of each year is dedicated to a week long campaign to publicize the law on prevention and control of occupational diseases. The “National Plan on Prevention and Control of Occupational Diseases (2016–2020)” and the “Healthy China 2030” plan clearly outlines indicators and roadmaps to protect worker’s health. A series of national action plans provide comprehensive strategies and guidelines to improve occupational health, which will address present and future challenges.
China has population of 1.39 billion people with 776 million workers, and the working population already accounts for 55% of the total population (1). Most people in China spend almost half their life in working, and with rapid socioeconomic development and the emergence of new technologies and new materials that have been extensively applied in industry, new and unidentified hazardous risks have threatened workers at their workplace. In 2015, the classification and catalogue of occupational hazards has been revised again by increasing the number of occupational hazards to 459 in 6 classifications (2). Data from the National Occupational Disease Reporting System reports a total of 23,476 new cases of occupational diseases in 2018 (3).
One occupational disease, occupational pneumoconiosis, is caused by exposure to dust in the workplace and accounted for more than 83% of total disease (Figure 1). Chemicals provide immense benefits to mankind, but many have significant negative health impacts, primarily due to their inherent chemistry and toxicity and can contribute to cancers, developmental malformations, and hereditary disease. With the rapid development of the industry, an estimated 100,000 new chemicals were produced annually around world. Although new cases of chemical poisoning reported in 2018 significantly declined to almost 50% when compared to the highest number of cases reported in 2009 (3), there is an urgent need to strengthen the capacities of monitoring, surveillance, and emergency response to chemical poisoning because of various levels of widespread exposure to chemicals, along with the occurrence of occupational and non-occupational hazards in the emergence of chemical poisonings.
In 2018, the World Health Organization (WHO) released new estimates on magnitude of disabling hearing loss, there are 466 million persons in the world with disabling hearing loss, and 91% (424 million) of these are adults (4). Occupational factors such as noise, chemical solvents, and lead contribute almost 50% of the cumulative risk assessment for hearing loss. The number of noise-induced deafness reported dramatically increased by 20% and 37% compared with data reported in 2016 and 2015, respectively, but there was a huge gap between cases of noise-induced deafness diagnosed and reported and the widespread of noise exposure at workplaces that endangered workers’ health including disabling hearing loss and cardiovascular disease (3).
The International Labour Organization (ILO) estimates that 1,000 workers die every day from work accidents and 6,500 die a day from a wide range of work-related diseases in the world. Every year, 2.78 million workers die from work-related accidents and work-related diseases, and of these, 2.4 million workers die from work-related diseases and another 3.74 million workers suffer from non-fatal work-related diseases occur annually (5). Circulatory diseases (31%), occupational cancers (26%), and respiratory diseases (17%) accounted for almost 3 out of every 4 work-related deaths (Figure 2).
Figure 2. International Labour Organization (ILO) estimates of death and injury from work-related diseases and fatal and non-fatal occupational accidents in 2018.
The patterns of work-related diseases and injury are changing around the world. The ILO published the first international list of occupational diseases in 1925 beginning with 3 diseases, and the revision of the international list of occupational diseases has been continuously revised with the most recent update in 2010 (6). This new revision of international list of occupational diseases contains 106 diseases including 9 open items in 4 classifications. The ILO international list of occupational diseases includes a range of occupational diseases recognized internationally from illnesses caused by chemical, physical, and biological agents to respiratory and skin diseases, musculoskeletal disorders, and occupational cancer, and mental and behavioral disorders have been included for first time in the ILO international list. In China, the list of occupational diseases was first published in 1956 beginning with 14 occupational diseases recognized officially, and the latest revision of the list was in 2013 (7). The new list of occupational diseases in China contains a total 132 diseases in 10 classifications, and in the structure of the list, classification from 1 to 4 are occupational diseases in target organs, 5 to 8 are occupational disease caused by exposed to hazards, 9 is occupational cancer, and 10 is other occupational diseases. The list of occupational diseases in China focused on the prevention and control of traditional occupational diseases such as pneumoconiosis and chemical poisoning. With industry revolution and behavioral change, some well-known occupational diseases such as pneumoconiosis and chemical poisoning are still widespread in China, but some new occupational diseases, such as work-related stress and musculoskeletal disorders (MSDs), are emerging as common threats worldwide.